Repair of complete atrioventricular canal in infancy

Abstract

AbstractResults of operative repair of complete atrioventricular canal defects (CAVCD) are improving due to: general advances in pre‐, intra‐, and postoperative care; a better understanding of the relevant pathological factors, principally of the left atrioventricular (A‐V) valve; a clearer definition of the path of the specialized conduction tissue; and the recognition of associated defects such as single left ventricular papillary muscles, ventricular hypoplasia, with or without malalignment of the common A‐V valve, coexistent ventricular septal defects, and double orifice left A‐V valves. Forty‐eight patients underwent repair from July 1980 through July 1984. Three patients died early and 2 late after the operation. One patient with an additional posterior ventricular septal defect (VSD) remained in complete heart block. Three patients required reoperation for residual left A‐V valve regurgitation and 1 for a residual VSD. In 20 recatheterized patients, mitral regurgitation was moderate in 4 and severe in 2. Pulmonary artery pressure (pulmonary/systemic arterial systolic pressure ratio) remained unchanged in only 1 patient with significant A‐V valve regurgitation. To avoid the development of pulmonary vascular obstructive disease, and based also on the trend of decreasing operative mortality and morbidity rates, primary repair of CAVCD is recommended within the first year of life.